What do patients complain about online: A systematic review and taxonomy framework based on patient centeredness

© 2019 Journal of Medical Internet Research. All rights reserved. Background: Complaints made online by patients about their health care experiences are becoming prevalent because of widespread worldwide internet connectivity. An a priori framework, based on patient centeredness, may be useful in identifying the types of issues patients complain about online across multiple settings. It may also assist in examining whether the determinants of patient-centered care (PCC) mirror the determinants of patient experiences. Objective: The objective of our study was to develop a taxonomy framework for patient complaints online based on patient centeredness and to examine whether the determinants of PCC mirror the determinants of patient experiences. Methods: First, the best fit framework synthesis technique was applied to develop the proposed a priori framework. Second, electronic databases, including Web of Science, Scopus, and PubMed, were searched for articles published between 2000 and June 2018. Studies were only included if they collected primary quantitative data on patients' online complaints. Third, a deductive and inductive thematic analysis approach was adopted to code the themes of recognized complaints into the framework. Results: In total, 17 studies from 5 countries were included in this study. Patient complaint online taxonomies and theme terms varied. According to our framework, patients expressed most dissatisfaction with patient-centered processes (101,586/204,363, 49.71%), followed by prerequisites (appropriate skills and knowledge of physicians; 50,563, 24.74%) and the care environment (48,563/204,363, 23.76%). The least dissatisfied theme was expected outcomes (3651/204,363, 1.79%). People expressed little dissatisfaction with expanded PCC dimensions, such as involvement of family and friends (591/204,363, 0.29%). Variation in the concerns across different countries' patients were also observed. Conclusions: Online complaints made by patients are of major value to health care providers, regulatory bodies, and patients themselves. Our PCC framework can be applied to analyze them under a wide range of conditions, treatments, and countries. This review has shown significant heterogeneity of patients' online complaints across different countries

Attitudes and associated factors of patients’ adoption of patient accessible electronic health records in China — a mixed methods study

Background: although patient accessible electronic health records (PAEHRs) offer great potential in enhancing the provision of patient-centered care and improving satisfaction, the adoption rate is still low. Currently, few studies are there for researchers and health organization leaders to understand patients’ thoughts and related factors of PAEHRs adoption in developing countries. China adopted more limited practices of PAEHRs, among which we selected Yuebei People's Hospital as an example.Objective: the study aimed to research patient attitudes toward PAEHRs use and the associated factors of patients’ adoption of PAEHRs in China, which is achieved by both qualitative and quantitative studies.Methods: this study employed sequential mixed-methods. The DeLone & McLean information systems (D&M IS) success model, Unified Theory of Acceptance and Use of Technology (UTAUT) and task-technology fit (TTF) model were used to guide the research. Finally, we collected 28 valid in-depth interview responses, 51 valid semi-structured interview responses and 235 valid questionnaire responses. The research model was tested and validated using data collected.Results: the findings of the qualitative study reveal that patients’ rate perceived task productivity and customer satisfaction as benefits, and poor-quality information as flaws. Results of the quantitative study show that the drivers of behavioral intention are performance expectance, effort expectancy and social influence; the predictors of use behavior are TTF and behavioral intention.Conclusion: it is necessary to consider PAEHRs’ task-tool role in patients’ adoption behavior. Hospitalized patients value PAEHRs’ practical attributes and attach much importance to the information content and application design

A new species of the toothed toad Oreolalax (Anura, Megophryidae) from Sichuan Province, China

Volume: 929Start Page: 93-11

A new species of the genus Leptolalax (Anura, Megophryidae) from Hunan, China

Hou, Yinmeng, Zhang, Mengfei, Hu, Fei, Li, Siyuan, Shi, Shengchao, Chen, Jun, Mo, Xiaoyang (2018): A new species of the genus Leptolalax (Anura, Megophryidae) from Hunan, China. Zootaxa 4444 (3): 247-266, DOI: https://doi.org/10.11646/zootaxa.4444.3.

Tin (Sn) Geochemical Mapping Based on a Fixed-Value Method: A Case Illustration in Gejiu Area, Southwest China

Geochemical maps play an important role in mineral resource exploration. There are three traditional methods for creating geochemical maps: the cumulative frequency method, the logarithmic interval method, and the Avg±k∗Std (where Avg and Std are the abbreviations of average and standard deviation, and k is a multiple of Std) method. However, with the increasing scope of the study area and cumulative data, the limitations of traditional methods, which depend on the amount of data, are exposed. A fixed-value method for Sn geological mapping is proposed to overcome the limitations of traditional methods. In the fixed-value method, Sn concentrations are divided into 19 levels on 18 fixed values ranging from 1 μg/g (corresponding to the detection limit) to 1000 μg/g (corresponding to the cut-off grade of Sn in hard rocks). The 19 levels are mapped in six color tones. The first to fifth levels are the lowest background areas in blue tones, which correspond to Sn concentrations ranging from the minimum to 3.4 μg/g. The sixth to ninth levels are high background areas in yellow tones corresponding to concentrations less than 10 μg/g, the 10th to 12th are low anomaly areas in pink tones less than 28 μg/g, the 13th to 15th are high anomaly areas in red tones less than 200 μg/g (corresponding to the placer cut-off grade), the 16th to 18th in gray tones less than 1000 μg/g, and the 19th level is in black corresponding to Sn ores with Sn concentration not less than 1000 μg/g. The fixed-value method along with three traditional methods was used to contour the Sn geochemical maps in the Gejiu area in Southwest China. The illustration results of the presented fixed-value method and three traditional methods for geochemical mapping of Sn are all feasible for Sn deposit exploration in the Gejiu area, Southwest China. Compared to traditional methods, the presented fixed-value method overcomes the flaws of traditional methods and is also more meaningful in geochemistry

Skeletal muscle stem cells confer maturing macrophages anti-inflammatory properties through insulin-like growth factor-2

Cytokines produced by immune cells have been demonstrated to act on muscle stem cells (MuSCs) and direct their fate and behavior during muscle repair and regeneration. Nevertheless, it is unclear whether and how MuSCs can also in turn modulate the properties of immune cells. Here, we showed that in vitro expanded MuSCs exhibited a potent anti-inflammatory effect when infused into mice suffering from inflammatory bowel disease (IBD). Supernatant conditioned by MuSCs similarly ameliorated IBD. This beneficial effect of MuSCs was not observed when macrophages were depleted. The MuSC supernatant was found to greatly attenuate the expression of inflammatory cytokines but increase the expression of programmed death-ligand 1 in macrophages treated with lipopolysaccharide and interferon gamma. Further analysis revealed that MuSCs produce a large amount of insulin-like growth factor-2 (IGF-2) that instructs maturing macrophages to undergo oxidative phosphorylation and thus acquire anti-inflammatory properties. Interestingly, the IGF-2 production by MuSCs is much higher than by mesenchymal stem cells. Knockdown or neutralization of IGF-2 abrogated the anti-inflammatory effects of MuSCs and their therapeutic efficacy on IBD. Our study demonstrated that MuSCs possess a strong anti-inflammatory property and the bidirectional interactions between immune cells and MuSCs have important implications in muscle-related physiological and pathological conditions